Nursing homes and assisted living in California

California has many care options for older adults, from small homes in a neighborhood to large residences with several levels of care. Here we explain the names you'll hear, how Medi-Cal can help and who to call for guidance.

What care settings are called here

• RCFE (Residential Care Facility for the Elderly): this is California's official name for assisted living. These residences serve people 60 and older who need help and supervision 24 hours a day, but not ongoing medical care. Many people call them assisted living or board and care homes.
• Skilled Nursing Facility (SNF): this is a nursing home, with nursing care 24 hours a day. It's for people with serious medical needs or who are recovering after a hospital stay.
• CCRC (Continuing Care Retirement Community): retirement communities that offer different levels of care in one place.

RCFEs and CCRCs are licensed by the California Department of Social Services (CDSS) through its Senior Care Licensing program (Community Care Licensing Division). Nursing homes (SNFs) are licensed by the California Department of Public Health (CDPH).

How Medi-Cal helps in California

Medi-Cal is the name of California's Medicaid program. These are the programs that matter most to families:

• Nursing home (SNF): Medi-Cal can pay for the stay when there is a medical need. Depending on their income, the person may have to pay part of the cost (their share of cost).
• Assisted Living Waiver (ALW): a Medi-Cal waiver that pays for care services in participating residences, but not rent or meals, which the resident pays for. It's for people with Medi-Cal who need the level of care a nursing home provides. It's only available in 15 counties, including Los Angeles, Orange, Riverside, San Bernardino, San Diego, Fresno, Kern and Sacramento. Spots are limited, and there is a waiting list. A Care Coordination Agency in your county does the assessment with a nurse.
• IHSS (In-Home Supportive Services): help with personal care and housework for people with Medi-Cal who live in their own home. You apply at your county IHSS office, and a social worker visits the home to do an assessment.

To apply for Medi-Cal, go to your county social services office or apply online at BenefitsCal. Income and asset rules change, so check your situation with the county or a professional.

How much care costs in California

According to CareScout's Cost of Care Survey 2025 (data from July to November 2025, published in March 2026), the median costs in California are:

• In-home caregiver (non-medical): $40 an hour.
• Adult day center: $94 a day.
• Assisted living (RCFE): $7,000 a month.
• Nursing home, semi-private room: $12,167 a month.
• Nursing home, private room: $15,178 a month.

These are reference figures. Actual prices vary a lot depending on the city and the level of care.

Who to call

• California Long-Term Care Ombudsman: a free, confidential statewide line, available 24 hours a day, for residents of nursing homes and assisted living and their families: 1-800-231-4024.
• Area Agency on Aging: to find your local agency, call 1-800-510-2020 or look up your county on the California Department of Aging website.
• Eldercare Locator (national line): 1-800-677-1116.

Tips for your family

• Check the license online. With the CDSS Find a Facility search tool, you can see whether an RCFE has a current license and read its visit reports. For nursing homes, use the CDPH's Cal Health Find. These are standard tools that help you decide with peace of mind.
• Ask about language. Many residences have staff who speak Spanish. On your visit, ask who will care for your loved one on each shift.
• If your county has the ALW, sign up early. Because there is a waiting list, it's best to call the Care Coordination Agency as soon as you can.
• Visit more than one place. Some residences have only a few residents, and others are larger, with more activities. Seeing both options helps you find the best fit for your loved one.

On hogaresparamayores.com, you can see the licensed care facilities in California and compare them at your own pace.